Obesity prevention for children with physical disabilities: a scoping review of physical activity and nutrition interventions

Abstract

Purpose: Children with disabilities are at higher risk of obesity, engage in less physical activity and report poorer quality dietary habits than their non-disabled peers. This study reviewed current evidence on interventions designed to facilitate weight management and/or weight-related behaviors (i.e. physical activity and/or healthy eating habits) in children with physical disabilities. Methods: A scoping review was performed using established methodology. Data from studies meeting specific inclusion criteria were extracted and analyzed using summary statistics, and common characteristics thematically identified. Results: Thirty-four articles were included in the synthesis. No long-term obesity prevention interventions were identified. The majority of research focused upon children with cerebral palsy, and had case study, quasi- or non-experimental designs. All interventions reporting positive outcomes (n = 18) addressed physical activity, with common themes including using motivational strategies for the child and child self-direction. Incremental increases in workload and engaging in strength training for longer than 15 minutes were also effective. Interventions targeting body weight/composition did not report success in the long term. Conclusions: A robust evidence base is lacking for long-lasting obesity interventions for children with physical disabilities. Current research provides some insights into the specific components that should be considered when planning such interventions in the future.

Implications for Rehabilitation

• Clinicians should be aware of the high risk of obesity, physical inactivity and poor diet in children with physical disabilities.

• The use of motivational strategies, child direction in activities and incremental increases in workload all appear promising approaches, yet require further evaluation.

• Evidence-based interventions are needed to improve both short- and long-term health and quality of life for children with physical disabilities.

• Disability
• health promotion
• obesity
• wellness

Acknowledgements

We acknowledge Pui-Ying Wong and Winky Yeung from the Holland Bloorview Kids Rehabilitation Hospital library for their support in the database searches.